GRADED A+ 2025
Sara S. is a 41−year−old patient who has just had a bone marrow transplant. The AGACNP knows that which
medication will be used to decrease her risk of graft−versus−host reaction? Immune globulin
Cyclosporine
Prophylactic
antibiotics
Systemic
corticosteroids
The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for
pheochromocytoma. He knows that which class of drugs should be available immediately to manage
hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?
Alpha−adrenergic antagonists
Beta− adrenergic antagonists
Arteriolar
dilators
Intravenous
Vasodilators
A 41−year−old male physician has a 6−week history of persistent painful, swollen, and stiff proximal
interphalangeal joints, wrists, and ankles. Using a step wise progression model, which would be the first
diagnostic test the AGACNP would order?
Radiography of hand and
wrist Check HLA – B27
Hepatitis B serology testing
Rheumatoid factor and anti−nuclear
antibody
Joint aspirate for microcrystals
Mr. S., a 49−year−old male, is brought to the emergency room by his roommate who relates that the patient
has been vomiting bright red blood for two days. He has a history of alcohol abuse. Current vital signs are as
follows: Temp 99.2o F, heart rate 110 bpm (sinus tachycardia), blood pressure 90/60 mm Hg, resp 32 bpm. He
is alert but lethargic and denies current abdominal pain. Which of the following is not indicated in the initial
management of this patient?
Immediate IV access
Laboratory screening, type and
,crossmatch
Endoscopy
Crystalloid infusion
A 38−year−old patient presents with symptoms of L5 nerve root impairment that have been ongoing for 3
weeks despite conservative treatment. All of the following statements regarding this case are true EXCEPT:
Normal findings on plain radiographs should be followed up with a CT Scan or MRI
immediately The L5 level is one of the most likely levels for disk herniation
Sensory findings may include diminished pain on the dorsum of the distal region of the foot
Motor findings may include weakness on extension of the great toe
Tendon reflexes are expected to be normal at the knee and ankle
R. R. is a 71−year−old female who presents with left lower quadrant pain that started out as cramping but has
become more constant over the last day. She reports constipation over the last few days but admits that for as
long as she can remember she has had variable bowel habits. Her vital signs are normal, but physical
examination reveals some tenderness in the left lower quadrant. Which diagnostic test is most likely to support
the leading differential diagnosis?
CT scan with IV, oral, and rectal contrast
CBC with WBC differential
Colonoscopy
Barium enema
A patient with chronic hepatic encephalopathy is being discharged home. Discharge teaching centers upon
long−term management strategies to prevent ammonia accumulation. Teaching for this patient includes
instruction about: Lactulose taken 20 g PO daily
Spironolactone taken 100 mg PO
daily
Protein intake of 50 g daily
Zolpidem taken 10 mg PO qhs.
Ms. Carpenter is a 28−year−old female who presents in significant pain; she indicates that the discomfort is in
the right lower quadrant. The discomfort is colicky in nature and has the patient in tears. Which of the following
associated findings increases the index of suspicion for ureteral colic?
Temperature > 102˚F
White blood cell count > 14,000 cells/μL
Vomiting
Hematuria
A 32−year−old patient who underwent an open splenectomy for a ruptured spleen is preparing for
discharge. An adult− gerontology acute care nurse practitioner reviews the potential complications with the
patient. The nurse practitioner emphasizes which instruction to the patient?
Continue antibiotics for 14 days
Follow up with primary care provider for
vaccinations
No international travel for five years
No weight lifting restrictions
When evaluating a patient with acute pancreatitis, which of the following physical or diagnostic findings is an
, ominous finding that indicates a seriously ill/potentially moribund patient?
Severe epigastric pain with radiation to the back
Abdominal guarding and rigidity
Grey Turner
sign
Obturator sign
Ted is a 22 year old male who fell on his right shoulder 2 days ago during a martial arts class. He is complaining
of inability to sleep on his right side and has pain whenever he tries to use his arm. He denies any sensory
changes in his hand. Nothing seems to make it better, even the ibuprofen he has been taking several times a
day.